CMA Files Request for Full Court Review to Stop Medi-Cal Cuts. On January 28, CMA filed a request for an en banc review by the Ninth Circuit Court of Appeals to stop California from implementing a 10% cut to Medi-Cal reimbursement rates. The lawsuit to prevent the cuts was originally filed by CMA in November 2011. Click here for more information.

Updated Analysis of Blue Cross of California Contract Now Available. This analysis is provided at no cost to SSVMS/CMA members. Click here to download your copy.

Anthem Blue Cross to Require Physicians to Notify Patients in Writing Before Referring Out-of-Network. Effective March 1, the payor's new "Advance Notice for Use of a Non-participating Provider Policy" (APN policy) requires this notice be given using the payor-provided APN form. The policy does not apply to emergencies. Click here for more information.

Palmetto GBA Announces New Audits. Palmetto GBA has expanded its procedure for specific audits, called probes, to include procedure codes 99204 and 99205 when rendered by providers with specific specialties. Click here for more information.

Palmetto GBA Loses Protest for Medicare Contract. On January 18, 2013, the Government Accountability Office (GAO) announced that they denied Palmetto’s protest, awarding the Medicare contract for Jurisdiction E (previously referred to as J1) to Noridian Administrative Services. Noridian and Palmetto are awaiting further direction from CMS on the transition plan, including a transition date, and CMA will work closely with them to help ensure a smooth transition. Until further direction is received, members should continue with business as usual. Please monitor the CMA and Palmetto websites for further announcements.

Some Medicare Claims Mistakenly Rejected Due to ZIP Code Error. Palmetto GBA has advised CMA that some claims filed in early January were mistakenly rejected because of a failure to load the 2013 ZIP code file into Palmetto's computer system. According to Palmetto, the erroneously rejected claims would have included message code MA114 (missing / incomplete / invalid information on where the services were furnished) and with dates of service of January 2-4, 2013. Palmetto will automatically adjust affected claims beginning January 28, 2013. Physicians may resubmit their claims or wait for the claims to be reprocessed. Click here for more information.

Nationwide Shortage of Isoniazid. The Sacramento County Department of Health and Human Services released a Health Alert on January 22, 2013, announcing a nationwide shortage of isoniazid (INH). Click here for more information.

American Medical Association Foundation Honors SSVMS Medical Student Member Olivia Campa with 2013 National Leadership Award. Olivia Campa, a third year medical student at University of California Davis School of Medicine, will be honored with the AMA Foundation’s 2013 National Leadership Award at their Excellence in Medicine Awards ceremony in Washington D.C., on February 11, 2013. Recipients of the award are recognized for demonstrating outstanding non-clinical leadership skills in advocacy, community service and education. Congratulations, Olivia!

The following webinars are offered at no cost to SSVMS/CMA members. Nonmember cost is $99. For more information, or to register, click on the links, or contact CMA’s member-help center, (800) 786-4262 or memberservice@cmanet.org.

FEBRUARY 5: Healthy Families: Important Program Changes Practices Need to Know, (Webinar), 12:15pm – 1:15pm. Presented by the Department of Health Care Services (DHCS). This webinar will provide an overview of the Healthy Families transition into Medi-Cal Managed Care, and will include a current status of the transition, a summary of the implementation phases in 2013, and DHCS’ monitoring and oversight of health plans participating in this transition. 1.00 CEU CREDIT.

FEBRUARY 6: HIPAA Compliance: The Final HITECH Rule, (Webinar), 12:15pm – 1:15pm. The HITECH Act created the extensive funding incentives and standards for adopting electronic health records; it also created new HIPAA rules or modified existing ones. Learn about changes to HIPAA and key steps medical practices can take to comply with these changes. 1.00 CEU CREDIT.

FEBRUARY 7: Impact of ICD-10, (Webinar), 12:15pm – 1:45pm. Learn what medical practices should be doing now to prepare for ICD-10 implementation. 1.50 CEU CREDITS.

FEBRUARY 13: E/M Services Review 2: History as Key Component in Selecting E/M Level, (Webinar), 12:15pm – 1:45pm. This course will cover history of present illness (HPI); review of systems (ROS); and past, family, and social history (PFSH). Documentation reminders, frequently asked questions (FAQs), common documentation and coding errors and helpful resources will also be included. Attendance at all four parts of the E/M Services Review series is worth 6 CEU credits (for medical office staff only). 1.50 CEU CREDITS.

FEBRUARY 27: Practice Mergers: How to Successfully Merge Physician Practices, (Webinar), 12:15pm – 1:15pm. This webinar discusses the elements and steps toward a successful merger, partnership or group formation. In the era of declining reimbursement, economic recessions and new organizations such as ACOs and foundation models, consolidating practices can result in economies of scale, reduction of overhead, increased power in contracting, increased net income, ability to recruit new partners and retire partners. Income distribution and overhead formulas as well as buy-in, buy-out formulas will also be discussed. 1.00 CEU CREDIT.

MARCH 6: Fraud and Abuse: Dangers and Defenses, (Webinar), 12:15pm – 1:15pm. Presented by the Department of Health Care Services (DHCS). This webinar will help you understand the importance of documentation, present suggestions for implementing internal controls, and increase awareness of preventive measures to protect your practice from fraud or abuse. 1.00 CEU CREDIT.

WALK WITH A DOC
This free walking program is sponsored by SSVMS and is open to anyone interested in taking steps for health. Walks are held on Saturday mornings at local parks and are led by SSVMS member physicians. Click here for more information, including meeting times and locations. Interested in leading a Walk? Contact Kris Wallach at kwallach@ssvms.org or (916) 453-0254.

Walk With a Doc Needs an Intern! SSVMS’ Walk with a Doc Program is looking for a student intern to help with program development and implementation. We could use help with program development, publicity, fund/partner development, physician leader recruitment and management, site selection, and registration/management on the day of each walk. This would be a wonderful opportunity for an undergraduate interested in health promotion and community organizing. If you know of a local college student who might be interested in this opportunity, please have them contact Kris Wallach at (916) 453-0254 or kwallach@ssvms.org.

To submit a community healthcare event for possible publication, email info@ssvms.org. Events should be physician-focused and should take place in or near El Dorado, Sacramento, or Yolo counties.

MARCH 22: Spring Surge 2013 – Food, Wine, Fashion & Fun, 6:30pm – 9:30pm, Arden Hills Resort Club & Spa. Serotonin Surge Charities invites you to join them for their 9th annual food, wine, and fashion show fundraiser for safety net medical clinics in the greater Sacramento region. For more information or to register, click here, or contact Tina Bozzini at tina.bozzini@kp.org or (530) 757-4121. For sponsorship and donor information, contact John Chuck at john.chuck@kp.org or (530) 757-4114.

The Benefits of Membership. When you join SSVMS/CMA, you hire a powerful professional staff to protect the viability of your practice. By protecting your practice from legal, legislative, and regulatory intrusions, your SSVMS/CMA membership lets you focus on what’s really important: your patients. Click here for more information on membership benefits.

About SSVMS

The Sierra Sacramento Valley Medical Society is dedicated to bringing together physicians from all modes of practice to promote the art and science of quality medical care and to enhance the physical and mental health of our entire community.